By Jill Arnold
The CDC just published the report Births: Final Data for 2009 (pdf). Here is the section titled Method of Delivery:
In 2009, the total cesarean delivery rate reached a record high of 32.9 percent of all births, a 2 percent increase from 32.3 percent in 2008 (Table 21). This is the 13th consecutive year in which the cesarean delivery rate has risen; this rate is nearly 60 percent higher than the most recent low of 20.7 percent in 1996 [8,12]. Since 2006, the cesarean delivery rate has increased approximately 2 percent every year, compared with average annual increases of 4 percent from 1997 through 2005. Data from the National Hospital Discharge Survey show similar trends in cesarean delivery rates since the mid 1990s [26,27].
Historically, cesarean delivery rates increase with increasing age of mother. In 2009, one out of two women aged 40 and older (49.5 percent) delivered by cesarean compared with less than one in four women under age 20 (23.1) (Table 22). This is also the case among women having singleton births (older women have higher rates of multiple births, which are more likely to be delivered by cesarean); see Figure 1. Cesarean delivery rates rose 1 to 2 percent from 2008 to 2009 for all maternal age groups 20 years and over. Since 1996, the cesarean delivery rate has increased more than 50 percent for all age groups; rates for women under 25 in 2009 were more than 60 percent higher than in 1996 (singleton births only; see Figure 1).
As in previous years, rates of cesarean delivery varied by race and Hispanic origin in 2009 (Table 22). Non-Hispanic black women were 8 percent more likely (35.4 percent) than non-Hispanic white (32.8) and 11 percent more likely than Hispanic women (31.6) to deliver by cesarean. For all race and Hispanic origin groups, cesarean delivery rates were higher in 2009 than in 2008. Since the most recent low in 1996, the cesarean delivery rate for non-Hispanic black women has increased 63 percent compared with approximately 58 percent for both non-Hispanic white and Hispanic women.
Rates of cesarean delivery vary by state. In 2009, rates ranged from nearly 40 percent in Louisiana (39.6) and New Jersey (39.4) to less than 23 percent in Utah (22.9) and New Mexico (22.8) (see Internet Table I-7). Half of all states had significantly higher cesarean rates in 2009 than in 2008. Massachusetts was the only state with a significant decline in its cesarean rate from 2008 to 2009 (2 percent).
Use of forceps or vacuum extraction during delivery decreased to 3.7 percent of births in 2009, from 3.9 in 2008 (Table E). Vacuum extraction declined from 3.2 to 3.0 from 2008 to 2009; the use of forceps was stable at approximately 0.7 percent. Among vaginal births only, 1 percent were delivered with the use of forceps, 4.5 percent with vacuum extraction, and 5.5 percent used either method. Rates of forceps and vacuum extraction have been declining since the mid 1990s; the 2009 rate for use of either method is 61 percent lower than in 1995 (9.4 percent of all births).
Two graphs that may be of interest are “Cesarean delivery rates by age of mother: United States, 1996 and 2009” and “Distribution of early term and full term births: United States, 1990 and 2006-2009.”
The report is an up-to-date source of data on birth trends in the United States. Please consider downloading the PDF to read in its entirety.